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Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria

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  • Sulaimon T Adedokun
  • Victor T Adekanmbi
  • Olalekan A Uthman
  • Richard J Lilford

Abstract

Objective: To examine the independent contribution of individual, community and state-level factors to health care service utilization for children with acute childhood illnesses in Nigeria. Materials and methods: The study was based on secondary analyses of cross-sectional population-based data from the 2013 Nigeria Demographic and Health Survey (DHS). Multilevel logistic regression models were applied to the data on 6,427 under-five children who used or did not use health care service when they were sick (level 1), nested within 896 communities (level 2) from 37 states (level 3). Results: About one-quarter of the mothers were between 15 and 24 years old and almost half of them did not have formal education (47%). While only 30% of the children utilized health service when they were sick, close to 67% lived in the rural area. In the fully adjusted model, mothers with higher education attainment (Adjusted odds ratio [aOR] = 1.63; 95% credible interval [CrI] = 1.31–2.03), from rich households (aOR = 1.76; 95% CrI = 1.35–2.25), with access to media (radio, television or magazine) (aOR = 1.18; 95% CrI = 1.08–1.29), and engaging in employment (aOR = 1.18; 95% CrI = 1.02–1.37) were significantly more likely to have used healthcare services for acute childhood illnesses. On the other hand, women who experienced difficulty getting to health facilities (aOR = 0.87; 95% CrI = 0.75–0.99) were less likely to have used health service for their children. Conclusions: Our findings highlight that utilization of healthcare service for acute childhood illnesses was influenced by not only maternal factors but also community-level factors, suggesting that public health strategies should recognise this complex web of individual composition and contextual composition factors to guide provision of healthcare services. Such interventions could include: increase in female school enrolment, provision of interest-free loans for small and medium scale enterprises, introduction of mobile clinics and establishment of more primary health care centres.

Suggested Citation

  • Sulaimon T Adedokun & Victor T Adekanmbi & Olalekan A Uthman & Richard J Lilford, 2017. "Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-14, March.
    • Handle: RePEc:plo:pone00:0173578
    DOI: 10.1371/journal.pone.0173578
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    1. Joseph, Magashi & Miho, Asela, 2020. "Household Socioeconomic Status and Health Care Demand for Childhood Fever and Diarrhea in Tanzania," African Journal of Economic Review, African Journal of Economic Review, vol. 8(3), November.
    2. Clifford Odimegwu & Marifa Muchemwa & Joshua O. Akinyemi, 2023. "Systematic review of multilevel models involving contextual characteristics in African demographic research," Journal of Population Research, Springer, vol. 40(2), pages 1-29, June.
    3. Burroway, Rebekah & Hargrove, Andrew, 2018. "Education is the antidote: Individual- and community-level effects of maternal education on child immunizations in Nigeria," Social Science & Medicine, Elsevier, vol. 213(C), pages 63-71.

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